Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia; Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Victoria, Australia.
Gynecol Oncol. 2022 Oct;167(1):42-50. doi: 10.1016/j.ygyno.2022.08.008. Epub 2022 Sep 3.
To better serve women with gynaecological cancers, we need a sound understanding of their health, wellbeing and needs. This study sought to explore these issues in a sample of Australian women before commencing curative radiotherapy.
We undertook a secondary analysis of baseline data from a supportive care trial (n = 311). Descriptive statistics were used to summarise responses to measures of wellbeing, general psychological distress, symptom distress, sexual function and vaginal changes, and supportive care needs. Pre-specified regression models were used to examine sources of variation in wellbeing and sexual function.
Women reported lower emotional, functional and physical wellbeing than population norms (all p < 0.001). The prevalence of general psychological distress was 31% (95% CI 26-36%). Distress caused by physical symptoms was typically low. Health system and information needs comprised eight of the top ten moderate-to-high supportive care needs. Most women reported no change in interest for physical contact or sex compared to pre-diagnosis, but some sexually active women (16-24%) reported smaller vaginal size, increased dryness, and more pain on intercourse. General psychological distress was a robust marker of poorer wellbeing and sexual function.
Before radiotherapy, a substantial minority of women with gynaecological cancers experience general psychological distress, reduced wellbeing and moderate-to-high health system and information needs. A model of comprehensive care incorporating assessment of unmet needs, general psychological distress, and sexual issues is recommended. Healthcare providers may require training to elicit and respond to a constellation of interrelated issues and access relevant services for women requiring additional support.
为了更好地为妇科癌症患者服务，我们需要充分了解她们的健康、幸福和需求。本研究旨在探讨接受根治性放疗前澳大利亚女性样本中的这些问题。
我们对一项支持性护理试验（n=311）的基线数据进行了二次分析。使用描述性统计来总结幸福感、一般心理困扰、症状困扰、性功能和阴道变化以及支持性护理需求的测量结果。使用预先指定的回归模型来检查幸福感和性功能变化的来源。
与人群正常值相比，女性报告的情绪、功能和身体幸福感较低（均 p<0.001）。一般心理困扰的患病率为 31%（95%CI 26-36%）。身体症状引起的困扰通常较低。健康系统和信息需求占前十大中度至高度支持性护理需求的八项。大多数女性报告与诊断前相比，对身体接触或性的兴趣没有变化，但一些有性生活的女性（16-24%）报告阴道变小、干燥增加和性交时疼痛更多。一般心理困扰是幸福感和性功能较差的有力标志。
在放疗前，相当一部分妇科癌症患者经历一般心理困扰、幸福感降低以及中度至高度的健康系统和信息需求。建议采用综合护理模式，包括评估未满足的需求、一般心理困扰和性问题。医疗保健提供者可能需要接受培训，以引出和应对一系列相互关联的问题，并为需要额外支持的女性提供相关服务。
